State Licensed DRG Auditor

Company: VirtualVocations
Location: Anaheim
Posted on: February 4, 2025

Job Description:

A company is looking for a Diagnosis Related Group - Auditor III - Appeals.

Key Responsibilities:

Review MS-DRG and/or APR-DRG provider appeals for accuracy in DRG assignment and reimbursement
Document appeal results clearly, citing appropriate coding guidelines
Identify and communicate audit trends and perform audits as needed

Required Qualifications:

7+ years of experience in MS-DRG and APR-DRG auditing
Expert knowledge of AHA Coding Guidelines and DRG reimbursement methodologies
Active AHIMA CCS certification
Experience with DRG encoder tools (3M, Webstrat, Pricers)
Prior experience managing provider DRG appeals

Keywords: VirtualVocations, Chino Hills , State Licensed DRG Auditor, Accounting, Auditing , Anaheim, California

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